Provider Demographics
NPI:1376854828
Name:PLANO TOTAL HEALTH PA
Entity Type:Organization
Organization Name:PLANO TOTAL HEALTH PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEMYON
Authorized Official - Middle Name:
Authorized Official - Last Name:NAROSOV
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:972-702-9310
Mailing Address - Street 1:PO BOX 797604
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75379-7604
Mailing Address - Country:US
Mailing Address - Phone:972-702-9310
Mailing Address - Fax:972-458-7111
Practice Address - Street 1:13601 PRESTON RD STE 625W
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-4902
Practice Address - Country:US
Practice Address - Phone:972-702-9310
Practice Address - Fax:972-458-7111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty